A Severe Case of Buruli Ulcer Disease with Pleural Effusions
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Date
2014-06-19
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PLOS Neglected Tropical Diseases
Abstract
Patient GO is an 8-year-old student
from Drobonso, a Buruli ulcer–endemic
community in the Sekyere Afram Plains
of the Ashanti region of Ghana. She
presented with a month’s history of a
painless nodule on the anterior chest
which started increasing in size rapidly
over the course of two weeks. After
applying herbal preparations on the lesion
and observing no improvement in symptoms,
she sought medical attention
through which a course of oral amoxycillin
was prescribed for a week. However,
her lesion continued to enlarge with
involvement of her anterior and posterior
chest walls and ulcerations over the left
anterior cervical triangle and midsternal
region. Upon the recommendation of a
former patient from the same endemic
region, she came to the Buruli ulcer clinic
at the Agogo Presbyterian Hospital on the
24th of February 2011. On examination,
the patient looked fairly stable and was
afebrile (36.9uC), not pale, and anicteric
with no regional lymphadenopathy. Her
chest was clinically clear with a respiratory
rate of 14 cycles/min. The most
significant finding was an extensive oedematous
lesion involving the chest and
neck regions with two deep ulcerations
(Figure 1). She weighed 31 kg at diagnosis
(95th centile in weight for age). Swab
samples obtained from the ulcer were
positive by PCR for IS2404, acid-alcoholfast
bacilli, and Mycobacterium ulcerans
culture on Lowenstein-Jensen culture
slopes.
Description
An article published by PLOS Neglected Tropical Diseases and available at doi:10.1371/journal.pntd.0002868
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Citation
PLoS Negl Trop Dis 8(6): e2868. doi:10.1371/journal.pntd.0002868